The mediation effects of white matter microstructural abnormalities on the associations between cerebral small vessel
Chaofan Sui1, Changhu Liang2, Yian Gao2
1Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Agingei, Ministry of Education, Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jing-wu Road, Jinan 250021, China; Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Background:
White matter (WM) microstructural deterioration is associated with a higher total cerebral small vessel disease (CSVD) burden, as assessed by magnetic resonance imaging (MRI) markers, and with more pronounced cognitive decline in CSVD patients. However, the relationships among CSVD burden, cognitive impairment and WM changes remain unclear. We aimed to characterize WM microstructural abnormalities in patients with different CSVD burdens and investigate the mechanism linking different CSVD burdens to cognitive decline.
Methods:
This study included 56 patients with severe CSVD burden (CSVD-s), 109 patients with mild CSVD burden (CSVD-m) and 81 healthy controls. We used diffusion tensor imaging (DTI) and tract-based spatial statistics to detect WM diffusion changes between groups and then explored the relationships between different CSVD burdens, WM diffusion changes and cognitive function, especially to quantitatively analyze the possible mediating effect of WM microstructural alterations on CSVD burden and cognitive function.
Results:
The CSVD-s group presented significantly decreased FA and increased AD, RD and MD in the forceps minor, bilateral anterior thalamic radiation (ATR), superior longitudinal fasciculus (SLF), corticospinal tract (CST) and inferior fronto-occipital fasciculus (IFOF). The simple mediation model revealed that the mean MD value of forceps minor and right IFOF, the mean FA value of the left CST and right IFOF, and the mean RD value of the left CST, SLF and right IFOF partially mediated the correlations between the CSVD burden and multiple cognitive scores.
Conclusions:
Our findings offer potential neuroimaging targets for intervening in and improving cognitive dysfunction in patients with different CSVD burdens.
Insights
White matter changes mediate cognitive decline in cerebral small vessel disease (CSVD) patients. Diffusion tensor imaging (DTI) reveals microstructural abnormalities linked to CSVD burden and cognitive impairment.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- White matter (WM) microstructural deterioration correlates with cerebral small vessel disease (CSVD) burden and cognitive decline.
- The precise interplay between CSVD burden, cognitive function, and WM changes requires further elucidation.
Purpose of the Study:
- To characterize WM microstructural abnormalities in patients with varying CSVD burdens.
- To investigate the mediating role of WM alterations in the relationship between CSVD burden and cognitive decline.
Main Methods:
- Diffusion tensor imaging (DTI) and tract-based spatial statistics were employed.
- Analysis included 56 severe CSVD, 109 mild CSVD patients, and 81 healthy controls.
- Mediation analysis quantified the effect of WM changes on cognitive function.
Main Results:
- Severe CSVD patients showed significantly reduced fractional anisotropy (FA) and increased axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) in specific WM tracts.
- WM diffusion changes, including MD in forceps minor/IFOF, FA in CST/IFOF, and RD in CST/SLF/IFOF, partially mediated the association between CSVD burden and cognitive scores.
Conclusions:
- WM microstructural alterations play a mediating role in cognitive impairment associated with CSVD.
- These findings highlight potential neuroimaging targets for therapeutic interventions aimed at improving cognitive function in CSVD patients.
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